Infants who crawl while skin-to-skin in the first hour after birth are more likely to effectively breastfeed postpartum.

PURPOSE: This study aimed to ascertain the relationship, if any, between prone newly-born infants' achievement of the crawling behavior described in Widström's 9 stages during immediate, continuous skin-to-skin with their mother during the first hour after birth and effective breastfeeding in the following 24-h.

METHODS

This observational descriptive study filmed 149 mothers who gave birth vaginally, January-February 2024, at a regional referral hospital in Uganda while skin-to-skin during the first hour after birth. Crawling behaviors, one of Widström's 9 instinctive stages of newborns after birth, were noted. Breastfeeding was assessed within 24 h of the birth and prior to discharge using the Lactation Assessment and Comprehensive Intervention Tool.

RESULTS

Pearson's Chi square was used to determine the statistical significance between the behavior of crawling during the first hour after birth, and effective breastfeeding (defined as bursts of 1:1 or 2:1 swallow ratio by cervical auscultation and/or observed rocker motion of the jaw) before discharge. Fifty newborns (33.6%) crawled in the first hour after birth during skin-to-skin contact. Crawling was significantly associated with effective breastfeeding before discharge (χ2(1, N = 149) = 6.97, p = .008), with both suck-swallow bursts (χ2(1, N = 127) = 8.57, p = .003) and rocker jaw motion (χ2(1, N = 119) = 4.77, p = .029).

CONCLUSION

The results of this study support the relationship between crawling toward the breast while prone during skin-to-skin contact in the first hour after birth and effective breastfeeding before discharge. Observing crawling behavior may help clinicians identify dyads who need priority breastfeeding assessment and support prior to discharge, particularly in low-resource settings.